A COVID-19 swab test may not be good for people with a history of sinus or skull base surgery

People who have had major sinus surgery should talk to their ENT doctor before having a COVID-19 swab test, a new study reveals.

Similarly, those performing a swab test should ask if the patient has undergone extensive sinus or skull surgery, said Philip G. Chen, MD, senior study author from the University of Texas Health Science Center at San Antonio (UT Health San Antonio).

“If so, other such test methods at the back of the neck should be performed,” said Dr. Chen, associate professor of head and neck surgery otolaryngology at the university’s Long School of Medicine Joe Joe and Teresa Lozano .

JAMA Otolaryngology-Head & Neck Surgery published the study March 4.

Online information about COVID nasopharyngeal swabs lacks information warning those who have had a wide sinus or previous skull base surgery, Dr. Chen said.

“There was no information on one of the 200 sites we studied online against a nasopharyngeal blind swab test in those with a history of sinus or skull base surgery,” he said.

Asked how often swabbing is done incorrectly, Dr. Chen said, “We don’t really know. But in a study of online videos by Higgins, et al., The authors found about half of the videos on how to make COVID -19 nasopharyngeal swabs were wrong. “

Issues include incorrect rod fishing on the swab and inadequate insertion depth. If the swab angle is too high, puncture may occur. The sinuses can partially protect the skull base, Dr. Chen said.

With injury from incorrect nasopharyngeal swab technology, although rare, may include cerebrospinal fluid leakage or severe bleeding.

Polymerase chain test through nasopharyngeal swabs is a test that is commonly used to detect SARS-CoV-2 infection.

Dr. Chen is a board-trained, allied-trained physiologist – the only alliance-trained physician of this rare specialty in San Antonio. Rhinologists are ear, nose and throat (ENT) subspecialologists with a special interest and experience in the medical and surgical treatment of nasal and sinus disorders.